How to Perform an Economic Healthcare Study

  • Jonathan EdgingtonEmail author
  • Xander Kerman
  • Lewis Shi
  • Jason L. Koh


Every society must face the challenge of allocation of limited resources to address healthcare needs. Orthopedic surgery is a specialty with some of the highest expenditures, yet treatments rarely address life-threatening ailments, instead targeting quality of life. It is therefore vital to demonstrate the value of these interventions through economic healthcare studies. Clinicians must understand the goals and methods of economic healthcare studies, which differ fundamentally from other clinical research projects. Economic healthcare studies frequently concern themselves with efficient care decisions, as well as equitable distribution of valuable care. Understanding and interpreting these results will help with allocation of finite resources and drive rational decision-making on both clinical and policy levels. While economic healthcare studies provide valuable information, the costs and benefits of medical interventions are frequently difficult to define. Despite these challenges, clinical researchers should study the economics of orthopedic care in order to provide optimal patient outcomes.


Economic evaluation Health economics Cost-minimization analysis Cost-effectiveness analysis Cost-utility analysis Cost-benefit analysis 


  1. 1.
    Brauer CA, Rosen AB, Olchanski NV, Neumann PJ. Cost-utility analyses in orthopaedic surgery. J Bone Joint Surg Am. 2005;87:1253–9. Scholar
  2. 2.
    Briggs AH, O’Brien BJ. The death of cost-minimization analysis? Health Econ. 2001;10:179–84. Scholar
  3. 3.
    Chang RW, Pellisier JM, Hazen GB. A cost-effectiveness analysis of total hip arthroplasty for osteoarthritis of the hip. JAMA. 1996;275:858–65.CrossRefGoogle Scholar
  4. 4.
    Daigle ME, Weinstein AM, Katz JN, Losina E. The cost-effectiveness of total joint arthroplasty: a systematic review of published literature. Best Pract Res Clin Rheumatol. 2012;26:649–58. Scholar
  5. 5.
    Givon U, Ginsberg GM, Horoszowski H, Shemer J. Cost-utility analysis of total hip arthroplasties. Technology assessment of surgical procedures by mailed questionnaires. Int J Technol Assess Health Care. 1998;14:735–42.CrossRefGoogle Scholar
  6. 6.
    Maniadakis N, Gray A. Health economics and orthopaedics. J Bone Joint Surg Br. 2000;82:2–8.CrossRefGoogle Scholar
  7. 7.
    Napper M, Newland J. Health economics information resources: a self-study course: U.S. National Library of Medicine; 2016.Google Scholar
  8. 8.
    Palsis JA, Brehmer TS, Pellegrini VD, Drew JM, Sachs BL. The cost of joint replacement: comparing two approaches to evaluating costs of total hip and knee arthroplasty. J Bone Joint Surg Am. 2018;100:326–33. Scholar
  9. 9.
    Porter ME. What is value in health care? N Engl J Med. 2010;363:2477–81. Scholar
  10. 10.
    Rajan PV, Qudsi RA, Dyer GSM, Losina E. The cost-effectiveness of surgical fixation of distal radial fractures: a computer model-based evaluation of three operative modalities. J Bone Joint Surg Am. 2018;100:e13. Scholar
  11. 11.
    Rajan PV, Qudsi RA, Wolf LL, Losina E. Cost-effectiveness analyses in orthopaedic surgery: raising the bar. J Bone Joint Surg Am. 2017;99:e71. Scholar
  12. 12.
    Reidpath DD, Olafsdottir AE, Pokhrel S, Allotey P. The fallacy of the equity-efficiency trade off: rethinking the efficient health system. BMC Public Health. 2012;12:S3. Scholar
  13. 13.
    Wisløff T, Hagen G, Hamidi V, Movik E, Klemp M, Olsen JA. Estimating QALY gains in applied studies: a review of cost-utility analyses published in 2010. Pharmacoeconomics. 2014;32:367–75. Scholar
  14. 14.
  15. 15.
    Recommendations from the second panel on cost-effectiveness in health and medicine | Guidelines | JAMA | The JAMA Network. Accessed 15 Feb 2018.

Copyright information

© ISAKOS 2019

Authors and Affiliations

  • Jonathan Edgington
    • 1
    Email author
  • Xander Kerman
    • 2
  • Lewis Shi
    • 1
  • Jason L. Koh
    • 3
  1. 1.Department of Orthopaedic Surgery and Rehabilitation MedicineUniversity of Chicago Medical CenterChicagoUSA
  2. 2.Pritzker School of Medicine, The University of ChicagoChicagoUSA
  3. 3.NorthShore Orthopaedic Institute, NorthShore University HealthSystemEvanstonUSA

Personalised recommendations